Basic Information
| Provider Information | |||||||||
| NPI: | 1013123918 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALICATA | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 590 STABLE RD APT Z | ||||||||
| Address2: | |||||||||
| City: | PAIA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967798123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082981991 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1356 LUSITANA ST | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085862900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 9929 | HI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.